Stigma impedes the social integration of persons recovering from psychiatric disability, especially those with criminal histories. Little is known about factors that lessen this stigma. Four hundred and four adults listened to one of four vignettes describing a 25-year-old male with schizophrenia and responded to a standard set of items measuring social distance. The individual who was gainfully employed (vs. unemployed), or who had a prior misdemeanor (vs. felony) criminal offense, elicited significantly less stigma. Employment may destigmatize a person coping with both psychiatric disability and a criminal record. Mental health services should encourage paid employment and other paths to community integration.

Results of large-scale program evaluations supplement other kinds of evidence regarding interventions for psychiatric disabilities. This paper describes an ongoing 11-year effort to evaluate supported employment services provided to persons with serious psychiatric disabilities by community mental health centers in one Midwestern state. Using an ecological perspective, the evaluation emphasizes multiple kinds of products and the careful development and maintenance of stakeholder relationships. Data from over 4600 individuals in supported employment programs demonstrate that services are effective and efficient, that these employees and employers are satisfied, and that stable employment may sharply reduce the overall costs of mental health care.